<p> If you have questions while completing this form, please email [email protected].  If you need additional space for answering the questions you may add an additional sheet of paper.</p><p>APPLICATION SUBMISSION DATE: Click here to enter a date. Section 1: COMMUNITY DETAILS </p><p>NAME OF THE COMMUNITY: Click here to enter text.</p><p>STATE: Click here to enter text.</p><p>POPULATION SIZE: Click here to enter text.</p><p>PERCENTAGE OF RESIDENTS ABOVE THE AGE OF 60: Click here to enter text.</p><p>NAME AND TITLE OF THE ELECTED OFFICIAL SIGNING THE OFFICIAL COMMITMENT: Click here to enter text.</p><p>OFFICE ADDRESS OF THE SIGNER: Click here to enter text.</p><p>Section 2: COMMUNITY CONTACT FOR THE AARP NETWORK OF AGE-FRIENDLY COMMUNITIES The community contact is the local staff member or volunteer who is primarily responsible for carrying out the community-level work — it is not the responsible AARP staff member.</p><p>NAME: Click here to enter text.</p><p>POSITION: Click here to enter text.</p><p>EMAIL ADDRESS: Click here to enter text.</p><p>TELEPHONE NUMBER: Click here to enter text.</p><p>Please describe the named person’s role in the city or community’s age-friendly initiative: </p><p>Click here to enter text.</p><p>Membership Application: AARP Network of Age-Friendly Communities – Page 1 Section 3: COMMUNITY ACTIVITIES, ENGAGEMENTS and COLLABORATIONS</p><p>1) Please provide a brief summary of the community policies, programs and services that are targeted toward older people and how the community plans to become more age-friendly.</p><p>Click here to enter text.</p><p>2) How will the community engage and involve older people in the process of becoming a more age- friendly?</p><p>Click here to enter text.</p><p>3) Briefly describe the mechanisms the community has or is planning to put in place to facilitate collaborative planning and implementation between different agencies and departments. Click here to enter text.</p><p>Membership Application: AARP Network of Age-Friendly Communities – Page 2 Section 4: NETWORK MEMBERSHIP Your answers to the following questions will help us complete your membership in the global age-friendly network and better enable us to understand how to support the network.</p><p>4) How do you hope to contribute to the AARP Network of Age-Friendly Communities and the World Health Organization Global Network of Age-Friendly Communities?</p><p>Click here to enter text.</p><p>5) What motivated your community to join the AARP Network of Age-Friendly Communities and the World Health Organization Global Network of Age-Friendly Communities?</p><p>Click here to enter text.</p><p>Click here to add a link to where we can find your logo. Or, send us your logo by email attachment to [email protected].</p><p>6) Please provide a digital (JPG, PNG or PDF) file or link of a logo or other image that represents your community. The image resolution should be at least 72 dpi. As an example of an image, here's ours ></p><p>Membership Application: AARP Network of Age-Friendly Communities – Page 2</p>